Atherosclerosis is the primary cause of death and disease in America, as well as in most of the developed countries of the world. The number of people in developing countries with this disease is increasing so much that by the year 2020, health professionals expect it will be the primary cause of death throughout the world, according to Jules Lam, M.D., Associate Professor of Medicine at the University of Montreal in the "The Merck Manual for Healthcare Professionals."
What is Coronary Atherosclerotic Disease?
Atherosclerosis literally means the hardening of the arteries. In coronary atherosclerotic disease, this process takes place in the coronary arteries of the heart. These are the arteries that supply blood to the heart itself. They supply the heart with the oxygen that it needs, so it can then supply blood and oxygen to all the tissues and organs of the body. The coronary arteries also supply blood to the parts of the heart that make it contract and pump blood, as explained by Elizabeth Corwin, Ph.D. in "Handbook of Pathophysiology."
Development of Disease
This disease develops because some type of injury damages cells that line the inside wall of an artery. As described by Dr. Corwin, because of the damage, the arterial wall lets substances pass through it, like fats and cholesterol. Inflammation begins, so platelets and white blood cells go to the site of injury. The platelets, white blood cells, fats and cholesterol will build up to form an area called a plaque. Plaques make the space inside of the artery smaller, which makes it harder for the red blood cells to pass. A blood clot can block the opening entirely.
Risk Factors
There are several recognized risk factors for coronary artery disease. They include high cholesterol levels, hypertension, diabetes mellitus, cigarette smoking, male sex, family history and age. High cholesterol levels, hypertension and diabetes are all risk factors because they increase the inflammation, according to Dr. Lam in "The Merck Manual for Healthcare Professionals." They all cause the body to make substances that add to the inflammatory response. Diabetes and cigarette smoking can also injure the arterial walls.
Major Symptoms
Michael Crawford, M.D., Interim Chief of Cardiology at the University of California, writes about the major symptoms in "Current Diagnosis & Treatment: Cardiology." People usually have a pain that feels like a heavy pressure or squeeze in their substernal area. This is the area in the chest beneath the sternum, or breastbone. The pain may then spread to the neck, jaw and left arm. Some type of severe emotional distress or physical exertion usually happens before it begins.
Prognosis
The prognosis, or most likely outcome, of people with coronary artery disease depends upon how much physical exertion triggers their chest pain and upon test results. A person who cannot attend to their everyday activities without having chest pain has a worse prognosis compared to someone who has pain only under heavy physical exertion, per Dr. Crawford in "Current Diagnosis & Treatment: Cardiology." The perfusion scan is a test to see how much of the heart is not getting blood and oxygen when someone with chest pain exercises. The more abnormalities there are in the test, the worse the prognosis.
References
- "Current Diagnosis & Treatment: Cardiology"; Michael Crawford, M.D.; 2009
- "Handbook of Pathophysiology"; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- The Merck Manual for Healthcare Professionals: Atherosclerosis
